Leeds Language College Ltd., On-Line Application Form

Leeds Language College Ltd., On-Line Application Form 2023

Your details will be sent directly to our administration team when you fill in the form and click the submit button at the end of the page.

Title*

Full Name*

First NameLast Name

Gender*

MaleFemale

Date of Birth*

DayMonthYear

Nationality*

Passport/ID Number*

Email Address*

Home Address in Your Country*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home Address in the United Kingdom (if you have one)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number 1*

Area CodePhone Number

Phone Number 2

Area CodePhone Number

Contact Details of English Speaking Family Member of Friend in Case of Emergency or Accident*

First NameLast Name

Friend's/Family's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Friend's/Family's Email Address*

Friend's/Family's Telephone Number*

Area CodePhone Number

What is your current level of English?*

What kind of English course are you interested in?*

What is your preferred course time?*

How many hours a week of classes would you like?*

When would you like to start your course? (Monday)*

DayMonthYear

When would you like to finish your course? (Friday)*

DayMonthYear

How many weeks do you want to study for? (please insert number)*

Have you ever studied English before or taken any international English examinations? If you have please tell us which examinations you have taken and your scores/marks in these exams?

Would you like us to arrange accommodation for you?*

How many weeks of accommodation do you need us to arrange for you?

What kind of accommodation would you like?

What kind of room would you like?

What will be your arrival date at the accommodation?

DayMonthYear

What will be your departure date from the accommodation?

DayMonthYear

Are you a smoker?

Do you need wheelchair access?

Do you have any allergies, special needs or disabilities?*

Do you have any strong dislikes or special requirements?*

When will you arrive in the UK?

DayMonthYear

When will you depart from the UK?

DayMonthYear

How would you like to pay for your course?*

Would you like to pay for your course in full or in instalments?*

How did you hear about the college?*

If you have a scanned copy of your passport or English qualifications you can upload them here and send them to us:

Upload a File

Please read Leeds Language College terms and conditions here before completing and submitting the form:

Terms and Conditions

Prices and Payment

Information Disclaimer

Leeds Language College Ltd is a data controller and is registered with the Information Commissioner’s Office as required under the Data Protection Act 1998. We will use any information gathered for Education administration purposes and will only process your personal data in accordance with our registration procedures and current data protection legislation. Information contained on this form will be disclosed to members of our staff as necessary.

How we use your information

Your contact details are being held by Leeds Language College Ltd on a database. This information will be shared with our administrative and managerial staff and external third parties acting on Leeds Language College Ltd.’s behalf, as necessary. Information will not be disclosed to external third parties without your consent.

Leeds Language College Ltd. may wish to process your personal information in connection with a variety of activities which may include course enrolment, accommodation arrangements, travel arrangements, visa procedures, accreditation reporting, sending communications to you and examination registration.

If you do not wish Leeds Language College Ltd. to use your personal data in this way, then you will not be able to enrol on a course.

By ticking (☑) the boxes and signing below, you accept that Leeds Language College Ltd. can process the data on this form to our staff as necessary.

I understand that by ticking this box I give my consent for Leeds Language College Ltd. staff to record sensitive personal information about me, to process and store it securely for the purposes of course enrolment, progression, attendance and communication with me.*

I understand and give my consent.

I understand that by ticking this box I give my consent for Leeds Language College Ltd. staff to record sensitive personal information about me, to process and store it securely in electronic and paper format, for the purposes of course enrolment, progression, attendance and communication with me. *

I understand and give my consent.

Signature - Please type your full name: I confirm that I have read and accepted all the terms, conditions, rules and regulations of enrolment and study at Leeds Language College Ltd. I agree to abide by the Leeds Language College rules of conduct.*

Date - Please select today's date:

DayMonthYear

Enter the message as it's shown*